As assisted reproductive technology (ART) procedures have been perfected in recent years, the success rate of these procedures has risen admirably while safety concerns have diminished. A live birth marks success in ART procedures and more healthy babies are born every year as a result of ART.

Some advances leading to increased safety and success include:

  • Less aggressive protocols to stimulate ovulation.
  • Transvaginal egg (oocyte) retrieval instead of laparoscopic surgery

A substantial body of medical evidence proves ART is increasingly safe for mothers and the children they bear but this data focuses more on conception rates and live births than on the mother’s experience with the procedures themselves. A team of researchers at the Emory University School of Medicine in Atlanta, Georgia, headed by Dr. Jennifer F. Kawwass, pored through more than a million ART records to identify any trends in the number or types of complications being experienced by ART patients and egg donors.

The Kawwass team turned to the US Centers for Disease Control and Prevention’s (CDC’s) National ART Surveillance System for complications arising from ART procedures involving fresh eggs; ART procedures involving frozen eggs were not included in the study.

Fertility specialists are required to report to the CDC’s surveillance system if any of these complications occur within 12 weeks of the initiation of a cycle involving ART:

  • Adverse reaction to medication
  • Anesthetic complications
  • Hemorrhage that requires transfusion
  • Hospitalization
  • Infection
  • Ovarian hyperstimulation syndrome (OHSS) diagnosed as moderate or severe
  • Patient death

Autologous Cycles

In 1,135,206 autologous cycles (where the patient’s own eggs are used), the Emory researchers discovered:

  • OHSS (ovarian hyperstimulation syndrome) is the most common complication, peaking at approximately 153.5 times out of every 10,000 cycles.
  • Hospitalizations peaked at 334.8 per 10,000 cycles.
  • Rates for other complications were fewer than 10 per 10,000 cycles.
  • The rate of all complications dropped from 2000 to 2011.
  • 58 deaths occurred: 18 were linked to ovarian stimulation; 40 occurred during pregnancy.
  • Maternal death rates in 2004 were 14.2 per 100,000 live births conceived via ART.
  • By 2008, maternal death rates had dropped to 1.6 per 100,000 ART-assisted live births.

Donor Cycles

Complications in donor-assisted cycles were significantly lower than in autologous cycles, with no evident trends. The researchers discovered no donor deaths as a result of ART but 13 recipient patients died during pregnancy.

According to the research team, "Increased awareness of the most common complication, OHSS, may prompt additional study to characterize predictors of this and other adverse events to inform the development of effective approaches necessary to decrease complication occurrence."


  1. Kawwass, Jennifer F., et al. "Safety of Assisted Reproductive Technology in the United States, 2000-2011." Letter. JAMA / The Journal of the American Medical Association 313.1 (2015). The JAMA Network. Web. 19 Jan. 2015.
  2. Storck, Susan. "Ovarian hyperstimulation syndrome." MedlinePlus. US National Library of Medicine, 5 Aug. 2013. Web. 19 Jan. 2015.